ABSTRACT Atrophic post-acne scars are typically caused by loss of dermal matrix resulting from inflammation-induced collagen destruction, among other things, due to increase in expression of matrix metalloproteinases. Material and methods. The study was carried out in two stages. At the first stage (n=43), genetic study of frequency distribution of ESR1, Col1A1, Col1A2, Col3A1, Col5A1, MMP1, MMP12, MMP2, MMP3, MMP7 gene polymorphisms was carried out. At the second stage, patients with severe acne (n=50) received systemic isotretinoin at standard dosage as the main treatment for at least 6 months. Upon reaching IGA 0—1, patients with atrophic post-acne scars were divided into two groups. Group 1 patients (n=24) used topical fixed combination of 0.1% adapalene and 2.5% benzoyl peroxide once a day for 6 months. Group 2 patients (n=26) received no treatment. Results. A comparative analysis of polymorphism of the studied genes carried out at the first stage showed statistically significant differences in distribution of alleles between the groups of patients. No relapses of the disease were observed in group 1 at the second stage. In group 2, 15.4% of the patients had new inflammatory elements by the 3rd month. In 3 months, group 1 demonstrated twofold increase in the number of patients with clean skin and 1.5-fold improvement of the qualitative characteristics and surface pattern of cicatrical skin changes associated with moderate scars; in 6 months, the number of patients with SGA rating of “almost pure skin” increased 7-fold in group 1, while group 2 patients demonstrated no positive dynamics in 3 and 6 months. Conclusions. The results of the study suggest the presence of certain genetic predictors of formation of atrophic post-acne scars. The fixed combination has a significant preventive effect on formation of scars, which was confirmed by the absence of new secondary elements; furthermore, the proportion of patients with SGA score of «almost pure skin» (barely noticeable scars) increased from 6.4% to 46.7% in the group, where coformulated drug was used and remained unchanged in the control group.